Though many
people were shocked by the
prominent child sex abuse scandals
that hit the news last fall,
psychiatrist R. Gregg Dwyer wasn't
one of them.

Dr. R. Gregg Dwyer
heads up MUSC's Forensic
Psychiatry Program and the
Sexual Behaviors Clinic and Lab,
which opened April 2011. To see
the video, visit http://tinyurl.com/7eb9bcs.

The director of
MUSC's Forensic Psychiatry Program
and the Sexual Behaviors Clinic
and Lab knows well the prevalence
rate and the need for research so
that sexual abuse behaviors can be
better understood and prevented.

The clinic,
located in West Ashley, is one of
a few on the East coast with the
capacity to conduct in a single
location clinical, psychological,
and physiological assessments of
sexual behaviors for use by the
criminal justice system and
treatment professionals.

"We work where
there's the intersection of
psychiatry and the legal system.
That could be the criminal legal
system or the civil legal system,"
said Dwyer, M.D., Ed.D.,
explaining the program's roles in
consulting, education and
research.

Thomas Uhde,
M.D., chairman of the Department
of Psychiatry and Behavioral
Sciences, said that the department
is one of the few centers in the
country that both treats victims
of abuse and is developing more
effective ways to prevent future
abuse by sexual predators.

"Limitations in
funding for the study of human
sexual behavior hinders the
development and implementation of
more effective predator prevention
programs. Perhaps the tragic news
highlighted in the media will
promote research in this area and
lead to more effective efforts to
address this major public health
problem."

In addition to
research, the MUSC Forensic
Psychiatry Program is the site of
the Sexual Behaviors Clinic, which
is one of two in the state with a
research certification. Program
personnel serve as consultants to
several state agencies and the
federal government on the topic of
sexual offending and to educators,
providing presentations to legal
and health care professionals.

Dwyer, who was
recruited by Udhe in 2010 from the
University of South Carolina's
Department of Neuropsychiatry and
Behavioral Sciences, has the legal
and medical background he needs to
navigate how the fields intersect.
Dwyer received his doctor of
education from Virginia Tech and
doctor of medicine from the
University of Arkansas for Medical
Sciences. After serving in the
Navy, Dwyer was commissioned a
civilian special agent with the
U.S. Naval Criminal Investigative
Service (NCIS), serving in field,
headquarters, operational and
staff positions and critical
incident peer counseling.

Dwyer, an
associate professor in MUSC's
Department of Psychiatry and
Behavioral Sciences, is board
certified in general, child and
adolescent and forensic psychiatry
and is a certified sex therapist
with the American Association of
Sexuality Educators, Counselors
and Therapists.

The forensics
program will augment victim
services already provided at MUSC.
The Department of Psychiatry and
Behavioral Sciences National Crime
Victims Research and Treatment
Center, directed by Dean
Kilpatrick, Ph.D., has a long
history of research and clinical
service to victims. MUSC's Sexual
Assault Nurse Examiners (SANE)
program targets helping sexual
assault victims get the medical
and legal assistance they need.

Dwyer said the
Forensic Psychiatry Program
further establishes MUSC's
expertise in forensic health care
and it will be influential in
spearheading research in an area
too few academic centers are
targeting.

"We need a lot
more research on sexual abuse
cases. It's difficult to get it
funded, and it's difficult to
conduct it because the people
you're trying to study, in many
cases, are in the custody of a
government agency that creates
issues in getting access for
research."

Funding can be
a challenge given the stigma and
confusion about offenders'
behaviors.

"Typically that
person doesn't want to engage in
that behavior. If it's the result
of an illness, they certainly
didn't decide they wanted to have
that illness any more than someone
wakes up in the morning and says
they want to have
insulin-dependent diabetes or
heart disease or cancer or bipolar
disorder. Nobody wants those and
would like to get rid of them if
they could."

Two federal
research grants he currently is
working on are "Protecting
Children Online: Using
Research-Based Algorithms to
Prioritize Law Enforcement
Internet Investigations," and
"Internet Crimes Against Children:
Development of a Typology of
Offenders for Use in Prevention,
Investigations and Treatment."

Dwyer said the
widespread use of the internet,
especially given children's access
and comfort with mobile
technology, opens up vast new
areas of research in terms of
sexually abusive behaviors and the
internet's impact on interpersonal
relationships. The goal is to
provide an educational component
for schools and parents about how
to be safer in that electronic
environment, inform law
enforcement about how best to
catch sexual predators who are
using the internet and therapists
about the best treatment for them.

Dwyer
recommends that parents and
educators address the issue openly
with children. There is useful
information and resources provided
by the National Center for Missing
& Exploited Children on
helping children avoid internet
sexual predators. It is
information he plans to update and
revise as MUSC research sheds more
light on the different types of
predators and why and how they
operate the way they do, he said.

"Part of safety
of children in any environment is
being aware of what a child is
doing in any setting and for a
child to be comfortable reporting
to that person when something
happens or that is uncomfortable
or upsetting," he said.
"One of the ways that someone who
abuses children is able to do that
is by keeping it a secret and by
keeping someone who may be able to
do something about it out of the
picture – isolating a child in
some form or fashion. The more
connected the child is with a
caregiver in their life — that
reduces the chance that this will
happen in their life."

The other
critical component is for
researchers and therapists to
understand the people who engage
in abusive acts to know how to
stop the behavior to prevent the
victimization of others.

The
Statistics
Adult retrospective show that 1 in
4 women and 1 in 6 men were
sexually abused before the age of
18 (Centers for Disease Control
and Prevention, 2006). This means
there are more than 42 million
adult survivors of child sexual
abuse in the U.S.Source:
Darkness to Light

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